贵州医科大学学报

2019, v.44;No.228(09) 1079-1083

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彩色多普勒检测子痫前期胎儿大脑中动脉血流动力学变化对不良妊娠结局的预测价值
Predictive Value of Fetal Cerebral Artery Hemodynamics in Pregnant Women with Preeclampsia Detected by Color Doppler for Adverse Pregnancy Outcomes

廖桂英;段庆红;周舟;石兢恒;
LIAO Guiying;DUAN Qinghong;ZHOU Zhou;SHI Jingheng;Department of Imaging, the Affiliated Hospital of Guizhou Medical University;Department of Ultrasound, Prenatal Diagnosis Center, the Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:探讨彩色多普勒血流影像分析子痫前期胎儿大脑中动脉(MCA)血流动力学阻力指标变化对胎儿不良结局的预测价值。方法:选取在产科住院并行超声检查的子痫前期孕妇及正常妊娠孕妇各35例,收集两组孕妇文化程度、孕次、产次、孕前体质量指数(BMI)、有无高血压家族史等临床资料,分析与子痫前期患病相关的风险因素;采用彩色多普勒超声检测对两组胎儿MCA血流动力学指标,比较两组胎儿大脑中动脉收缩期峰值流速(MCA PSV)、大脑中动脉舒张末期血流速度(MCA EDV)、大脑中动脉搏动指数(MCA PI)、大脑中动脉阻力指数(MCA RI)及大脑中动脉收缩期与舒张末期血流速度比值(MCA S/D);比较两组孕妇妊娠不良结局的发生率,通过ROC曲线筛选MCA频谱参数中对不良妊娠结局有预测价值的指标。结果:与子痫前期患病有关的影响因素有文化程度、孕前BMI、高血压家族史(OR=0.517、1.322、2.931);子痫前期组MCA EDV高于正常妊娠组,MCA S/D、PI及RI显著低于正常妊娠组(P<0.001);子痫前期组不良结局的发生率显著高于正常妊娠组(P<0.05);ROC曲线分析显示,MCA S/D、PI及RI对胎儿不良结局均有中等预测价值(P<0.05)。结论:子痫前期患者胎儿MCA PI、MCA RI、MCA S/D均降低,3项指标检测对对胎儿不良结局的有一定的预测价值。
Objective: To investigate the predictive value of hemodynamic resistance index of fetal middle cerebral artery(MCA) in pregnant women with preeclampsia by color Doppler imaging.Methods:Thirty-five pre-eclampsia pregnant women were enrolled as PE group and 35 normal pregnant women as control group.The information about the educational level,pregnancy history,birth history,body mass index(BMI) before pregnancy,and family history of hypertension were collected.The risk factors associated with preeclampsia were analyzed.The hemodynamic parameters of fetal MCA were detected by color Doppler ultrasound.We compared the peak systolic velocity(PSV),end-diastolic blood flow velocity(EDV),pulsation index(PI),resistance index(RI),and ratio of systolic and end-diastolic blood flow velocity(S/D).The incidence rates of adverse pregnancy outcomes in the two groups was compared.ROC curve was used to evaluate the predictive value of MCA spectral parameters to predict adverse pregnancy outcomes.Results:The factors associated with preeclampsia included education,pre-pregnancy BMI,and family history of hypertension,and their odds ratios(OR) were 0.517,1.322,and 2.931,respectively.EDV was greatly higher in PE group than that in control group,while S/D,PI and RI were significantly lower in PE group than those in control group(P<0.001).The incidence rate of adverse outcomes was higher in the PE group than that in control group(P<0.05).ROC curve Analysis showed that PI,RI and S/D had moderate predictive value for fetal adverse outcomes(P<0.05).Conclusion:The PI,RI and S/D of fetal MCA were not only decreased in pregnant women with preeclampsia patients,but also are of certain predictive values for fetal adverse outcomes.

关键词(KeyWords): 彩色多普勒;子痫前期;胎儿;大脑中动脉;妊娠结局
color Doppler imaging;preeclampsia;fetus;middle cerebral artery;pregnancy outcomes

Abstract:

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基金项目(Foundation): 贵州省科技厅联合基金项目[黔科合LH字(2015)7421号]

作者(Author): 廖桂英;段庆红;周舟;石兢恒;
LIAO Guiying;DUAN Qinghong;ZHOU Zhou;SHI Jingheng;Department of Imaging, the Affiliated Hospital of Guizhou Medical University;Department of Ultrasound, Prenatal Diagnosis Center, the Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2019.09.018

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